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Gum Problems (cont.)

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What are signs and symptoms of gum problems?

Healthy gums should appear coral pink and firm without bleeding. Signs and symptoms of gum inflammation include redness, swelling, bleeding, and pain. Gums that bleed and/or feel sore while brushing is an indication of a problem. Receding gums may also be a sign of gum disease. Gums recede as a result of the destruction of the underlying bone surrounding the teeth. Once the bone is lost, the gums recede and expose the root surface of a tooth.

A discolored area or an ulceration that does not heal within two weeks are signs of a gum problem that could be unrelated to inflammation or gum disease.

How are gum problems diagnosed?

A periodic gum exam performed at the dental office measures the spaces between the gum and teeth called "periodontal pockets," the amount of root that is exposed for each tooth called "gum recession," and other signs of bone loss. Collectively, these measurements give an indication of the overall health of the gums and what areas are problematic. Other indicators of gum problems include the presence of bleeding with measurements, gum redness, gum swelling, or a persistent sore or mass that lasts for more than two weeks. If necessary, a biopsy of the affected tissue is performed for diagnosis.

Can gum problems be a sign of something serious?

Given the fact that gum disease is the leading cause of tooth loss, having healthy gums is certainly something for which we should strive. Loss of teeth can negatively impact an individual in many ways through loss of nutrition, psychosocial concerns, and self-esteem issues.

Gum problems have been linked to several systemic diseases, most notably, heart disease. Inflammation appears to be the key factor that links heart disease to gum problems. Research suggests that having gum disease increases the risk of heart disease in an individual.

A discolored area, lump, or mass that appears to persist for longer than two weeks may be a sign of oral cancer. Early diagnosis by a health-care professional is crucial to improve treatment outcomes in this situation.

What is the treatment for gum problems? What are home remedies for gum problems?

A gum exam performed by a dentist can determine the best way to treat a gum problem. Deep gum pockets may indicate advanced gum disease. Gum treatment can begin at the dental office with a thorough dental cleaning. For more advanced gum problems that persist after initial treatment, a gum specialist ("periodontist") is recommended for treatment.

In the case of gingivitis, a professional dental cleaning may be needed to remove the buildup of tartar and plaque around the teeth. This procedure allows the gums to heal. Additionally, specific oral hygiene instruction and a recommended schedule for routine care are equally important to maintaining gum health.

For gum disease, treatment is more involved. The first step usually involves a more thorough deep professional dental cleaning called "scaling and root planing." This removes the tartar deposits and plaque that are deeply sequestered in the pockets of the gums. Medications can also be employed to control bacteria infecting the gums. The medications come in the form of antimicrobial (antibacterial) oral rinses, oral antibiotics, and antibiotics placed directly into the gum pockets. Lastly, there is gum surgery to treat areas that do not respond to scaling and root planing and/or medications. The goal of gum surgery is to remove diseased tissue, preserve the remaining gums and bone, and create an environment that is easy to keep clean.

Usually, gum recession is left alone unless there is an extensive amount of recession that compromises the health of the tooth or there is a cosmetic concern. A procedure called a "gum graft" may be performed that takes tissue from another area in the mouth (such as the roof of the mouth) and surgically grafts it onto the area of recession.

For a gum abscess, scaling and root planing is performed to clear out debris, diseased tissue, and any pus that may be present. The area is irrigated with antimicrobial rinses and may have antibiotics directly placed into the pocket. Oral antibiotics may also be prescribed to help control the infection. Once the abscess disappeared, the area can be assessed for further treatment such as surgery to avoid a reoccurring gum problem.

At home remedies after dental professional care may help sooth sore gums. An oral rinse can be made up of 1/4 teaspoon baking soda, 1/8 teaspoon salt, and 1 cup of warm water. Regularly brushing teeth well and massaging gums at the gumline with a fluoride toothpaste can help eliminate dental plaque and debris to promote further healing. Additionally, flossing to reach between teeth is essential to maintain gum health.

Gum (oral) cancer treatment varies based on the stage of disease. Treatment modalities include surgery, chemotherapy, and radiation. A combination of treatment modalities are often used.

What are the complications with gum problems?

Gum problems that go untreated usually progress to more advanced stages depending on the primary problem. For gingivitis and periodontal disease, the biggest complication is jawbone deterioration and eventual tooth loss. Untreated, a gum abscess will grow and allow bacteria to enter the bloodstream to infect the entire body. Oral cancer that goes undetected will progress and spread.

What is the prognosis for gum problems?

The prognosis for gum problems largely depends on when the condition is discovered and treated. Gum problems treated in the early stages have the best prognosis, and the disease process can be reversed. This is especially true of gingivitis, which is a reversible condition. Conversely, periodontal disease has irreversible effects due to the bone loss that can never be regained. Given that periodontal disease is the leading cause of tooth loss, the prognosis can range from fair to hopeless depending on the level of disease present.

For oral cancer, early diagnosis is crucial for the best treatment outcome. The latest data shows that five-year survival after the diagnosis of oral cancer is 57%. Survival rates are higher for cancers diagnosed in the early stages.


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